Dufault M, et al., J Pract Prof Nurs 2021, 5: 024 DOI: 10.24966/PPN-5681/100024
HSOA Journal of Practical and Professional Nursing Research Article
Outcomes of Integrating Smart Phrase Interface Technology to Improve Cancer Symptom Management Dufault M1*, Dalky A2, Ritz J3, Begnoche M4, Chauvin M5, Cherenzia K6, Corrente J7, Laquale P8 and Machan J9 1
Professor, College of Nursing, University of Rhode Island, USA
Assistant Professor, Health Management and Policy Department, Jordan University of Science and Technology, Jordan
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Clinical Nurse Manager, Lifespan Cancer Center, Newport Hospital, USA
Nursing Safety and Quality Manager, Rhode Island Hospital, Lifespan Cancer Center, USA
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Program Manager, Lifespan Cancer Center Address: Rhode Island Hospital, USA Clinical Nurse Specialist, The Miriam Hospital, Lifespan, USA
Clinical Manager, Radiation Oncology Clinic, Lifespan Cancer Center Address: Rhode Island Hospital, USA
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Keywords: Nursing symptom management; Smart phrase; Telephone triaging; Translational research
Staff Nurse, Lifespan Cancer Center, Newport Hospital, USA
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a 6-step collaborative translating-research-to-practice model as process, Task-Technology-Fit Theory guided patient/nurse outcome evaluation. Analysis of repeated-measures using Generalized Linear Mixed Models, hierarchical regressions constructed the full variety of outcomes (p<.05). Analysis of patient outcomes of 375 telephone-triaged calls at each of five data-collection points found patient satisfaction on managing chemotherapy side effects, fatigue, and perceived safety/security improved significantly 6 months following smart phrase integration. Smart phrase usability and utilization increased, nursing documentation time decreased, and self-perceived effects on job performance increased for less-experienced oncology nurses from pre-to-6-month-post implementation. Evidence based approaches to standardize telephone-triage symptom assessment, well-embedded into practice, documented in the EHR, highly reliable, sustainable, and widely disseminated show promise for enhancing patient/family engagement, and improving job performance in novice tele-triage oncology nurses.
Adjunct Associate Professor Psychology, University of Rhode Island, USA
Abstract Assessing cancer treatment-related symptoms is challenging for frontline telephone-triage nurses toggling multiple electronic health record (EHR) screens for information on toxicity-risk predictors while simultaneously providing over-the-phone emotional support. Decision-support tools embedded into computer-telephone interface software, called smart phrases, are not widely used nor empirically evaluated for usability and remote symptom management impact. The process and outcomes of designing and empirically evaluating a telephone-triage smart phrase embedded into the EMR of a northeast multi-site cancer center serving 14,000 patients is described. Using
*Corresponding author: Dufault M, Professor, College of Nursing, University of Rhode Island, USA, Tel: +1 4017884116; Email: mdufault@uri.edu Citation: Dufault M, Dalky A, Ritz J, Begnoche M, Chauvin M, et al. (2021) Outcomes of Integrating Smart Phrase Interface Technology to Improve Cancer Symptom Management. J Pract Prof Nurs 5: 024. Received: January 26, 2021; Accepted: February 12, 2021; Published: February 19, 2021 Copyright: © 2021 Dufault M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction Communication errors are the most frequent cause of sentinel events in United States healthcare with oncology tele-health particularly at risk [1]. Assessing cancer treatment-related symptoms remotely is significantly error-prone for frontline telephone-triage nurses toggling multiple Electronic Health Record (EHR) screens for toxicity-risk predictors while simultaneously providing over-thephone emotional support. Evidence-based approaches to improve and standardize telephone-triage symptom assessment, well-embedded into nursing practice, documented in the electronic health record (EHR), highly reliable, sustainable, and widely disseminated are needed to reduce cancer treatment toxicity risks and enhance patient/ family engagement and comfort. Clinician-driven telephone-triaging and clinical pathways have been used to safely, effectively and efficiently manage symptoms using evidence-based algorithms as early as 1999 [2,3]. Limited recent attempts to interface these within the electronic health record (EHR) show promise to improve care transitions, handoff communications, access, nurse-patient relationships and patient/ family education; decrease emergency room visits, delays in care, and readmissionrelated hospital-acquired infections [4-6]. Despite these advances, significant challenges to implementing high quality, cost effective remote triaging exist [7,8]. Major barriers include clinician lack of knowledge, computer skills, and confidence to remotely assess, triage, and guide patients in self-care for symptom treatment, time management, discomfort in not recommending use of the emergency room, documentation issues, and lack of user-friendly access to software [9-12,4,6].